| NPI | 1609321801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 8811) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2265093) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2022-06-06 |