| NPI | 1700412111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 10250) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 345768) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2022-10-04 |