| NPI | 1912524521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 12.009867) |
| Additional Taxonomies | 163WL0100X Registered Nurse Lactation Consultant (Licence: CT 137656) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2021-08-11 |