| NPI | 1770215279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11124) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CT 97560) |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2022-11-07 |