| NPI | 1154973030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.008395) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0122554) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-08-21 |