| NPI | 1871801605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 5927) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336436) | 
| Enumeration Date | 2010-09-14 | 
| Last Update Date | 2024-10-15 |