| NPI | 1912257114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F337218-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 04985) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2019-09-03 |