| NPI | 1124420484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 010079) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 971) |
| 363L00000X Nurse Practitioner (Licence: CT 10079) | |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2022-07-11 |