| NPI | 1780257824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 12.011360) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 2334513) |
| 363LF0000X Nurse Practitioner Family (Licence: MA RN2334513) | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2022-12-21 |