| NPI | 1366964660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 7222) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 109129) |
| Enumeration Date | 2017-07-09 |
| Last Update Date | 2018-10-29 |