| NPI | 1649083692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 124966) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 124966) |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-08-29 |