| NPI | 1720795727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350929) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 63875) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 011389) | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2023-02-02 |