| NPI | 1760021539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 8667) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8667) |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2023-11-01 |