| NPI | 1215602115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9506) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 9506) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2021-09-29 |