| NPI | 1003487851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 11158) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 77861) |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2022-10-31 |