| NPI | 1700492006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 9089) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 9089) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2022-04-07 |