| NPI | 1871594788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 002122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F332392) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2023-12-15 |