| 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 |