| NPI | 1467091256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 12.008700) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 090499) |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2020-01-28 |