| NPI | 1942844949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8629) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.136002) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2020-06-06 |