| NPI | 1679024541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 12.006741) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: RI 02246) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F309504-01) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: ME CNP191291) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NH 081611-23) | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2020-12-08 |