| NPI | 1699561159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 15136) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 196260) |
| Enumeration Date | 2025-04-18 |
| Last Update Date | 2026-06-01 |