| NPI | 1811339906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7623) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F338060-1) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2019-04-05 |