| NPI | 1225816036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 12450) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 135319) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 12.012450) | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2025-06-17 |