| NPI | 1225764277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 173437) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 173437) |
| Enumeration Date | 2022-07-30 |
| Last Update Date | 2022-09-18 |