| NPI | 1679124259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003561) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10979) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2023-06-20 |