| NPI | 1992370241 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12753) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 202104629NP-PP) | 
| Enumeration Date | 2021-05-20 | 
| Last Update Date | 2024-09-18 |