| NPI | 1982682092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 002750) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18495) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 192059) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2022-05-02 |