| NPI | 1710520739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 008488) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8488) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-11-25 |