| NPI | 1578154530 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 9482)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 9482)  | 
| Enumeration Date | 2021-02-01 | 
| Last Update Date | 2024-07-01 |