| NPI | 1710630801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11116) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 11116) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2023-01-30 |