| NPI | 1407587041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 10749) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 146340) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-08-15 |