| NPI | 1548875776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 11641) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 82201) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2023-04-19 |