| NPI | 1740617059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.013925) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 676294) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2025-07-11 |