| NPI | 1164765921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 10409) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: NY 631315) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 339489) | |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2022-05-20 |