| NPI | 1083866958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 4950) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: NY 430430) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 340465) | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2019-01-25 |