| NPI | 1508309774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9652) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R231763) |
| 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.019912) | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2021-11-22 |