| NPI | 1891278529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7850) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 7850) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 7850) | |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-10-31 |