| NPI | 1720137730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 203176) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 900139) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 1043889967) | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: CT 1992372403) | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: NJ 1992372403) | |
| 363L00000X Nurse Practitioner (Licence: PA SP027685) | |
| 363L00000X Nurse Practitioner (Licence: NJ 26NJ14867600) | |
| 363L00000X Nurse Practitioner (Licence: NC 900139) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2023-11-14 |