| NPI | 1124543632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 7139) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 7139) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 7139) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 7139) | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2020-06-16 |