| NPI | 1770139727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8515) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.106554) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2022-11-25 |