| NPI | 1255482147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 8776) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 303909) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-04-11 |