| NPI | 1528680063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN10018359) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 009023) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2025-02-11 |