| NPI | 1154951341 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 8427)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 8427)  | 
| Enumeration Date | 2020-01-16 | 
| Last Update Date | 2020-07-01 |