| NPI | 1790947653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 4396) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F335503) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2022-07-21 |