| NPI | 1770054595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8055) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 101155) |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2019-01-23 |