| NPI | 1336612175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 7932) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 126788) |
| 208000000X Pediatrics (Licence: CT 7932) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: CT 7932) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 088756-23) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 7932) | |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2022-12-19 |