| NPI | 1245551639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 4387) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 076404) |
| 363L00000X Nurse Practitioner (Licence: CT 4387) | |
| Enumeration Date | 2010-06-20 |
| Last Update Date | 2019-04-16 |