| NPI | 1962990291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7549) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.007549) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2025-01-14 |