| NPI | 1619958196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 7100) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 176035) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2022-11-12 |