| NPI | 1821407925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016093) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2276527) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 6460) | |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2023-06-14 |