| NPI | 1720579840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11328) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018464) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2022-12-14 |