| NPI | 1740634039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 006229) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 006229) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-08-23 |