NPI | 1316406655 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11419) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2280403) |
Enumeration Date | 2019-03-17 |
Last Update Date | 2023-08-16 |