| NPI | 1821051061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CT 228444) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 000239) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2025-01-14 |