| NPI | 1659935252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CT 8179) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 8179) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 8179) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CT 8179) | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2021-08-25 |