| NPI | 1376153635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9176) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 159553) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-10-23 |