| NPI | 1871135962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8491) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 71614) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2023-09-08 |