| NPI | 1619644291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9974) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 163713) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-10-12 |