| NPI | 1790707180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004847) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY P330828-1) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2018-06-21 |