| NPI | 1679940282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6261) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339789) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2021-09-23 |