| NPI | 1093119216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 5951) |
| Additional Taxonomies | 163WU0100X Registered Nurse, Urology (Licence: CT 88008) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN252020) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 5951) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2023-12-13 |