| NPI | 1932716628 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9249) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 345796) | 
| Enumeration Date | 2020-09-26 | 
| Last Update Date | 2022-02-06 |