| NPI | 1649750282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7634) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018613) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2023-11-06 |