| NPI | 1659936615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 8212) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.008212) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2020-10-12 |