| NPI | 1912779208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12725) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 143349) |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2026-06-29 |