| NPI | 1649713926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 6838) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 12.006838) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2020-10-01 |