NPI | 1083808273 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT Cert # F0707246) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 3689) |
Enumeration Date | 2007-08-30 |
Last Update Date | 2023-03-07 |