| NPI | 1790464501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 12120) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 142496) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-07-19 |