| NPI | 1871206755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12723) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 350827) |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2024-10-02 |