| NPI | 1356963128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9149) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E59656) |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-09-01 |