| NPI | 1790243632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8183) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F343988) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-04-29 |