| NPI | 1710767595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12415) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 162274) |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2023-10-15 |