| NPI | 1548612518 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 005943) | 
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CT 76657) | 
| Enumeration Date | 2016-07-01 | 
| Last Update Date | 2022-01-24 |