| NPI | 1225764277 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11004)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 173437)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: CT 173437)  | |
| Enumeration Date | 2022-07-30 | 
| Last Update Date | 2025-02-13 |