| NPI | 1730883869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 13579) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2343426) |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2024-08-01 |