| NPI | 1285258673 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8950) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8950) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-02 | 
| Last Update Date | 2024-01-29 |