| NPI | 1649711631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6967) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 106900) |
| 163W00000X Registered Nurse (Licence: MA RN2303788) | |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2019-08-07 |