| NPI | 1578973905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 005762) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005762) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2021-09-24 |