| NPI | 1689155004 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 7776) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 7776) | 
| Enumeration Date | 2018-08-23 | 
| Last Update Date | 2023-03-21 |