| NPI | 1780183988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 7941) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2298915) |
| Enumeration Date | 2018-02-03 |
| Last Update Date | 2021-11-11 |