| NPI | 1093390833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9576) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 120027) |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2021-03-29 |