NPI | 1255854931 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 010200) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN285396) |
363L00000X Nurse Practitioner (Licence: CT 010200) | |
Enumeration Date | 2017-07-25 |
Last Update Date | 2022-09-20 |