NPI | 1740876036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2306620) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 282NC2000X) |
Enumeration Date | 2020-12-21 |
Last Update Date | 2025-02-12 |