| NPI | 1619584026 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 009215) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 9215) | 
| Enumeration Date | 2020-09-29 | 
| Last Update Date | 2020-11-03 |