| NPI | 1033550801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 006530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2269721) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2018-09-14 |