| NPI | 1659005742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10831) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 143449) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2022-08-11 |