| NPI | 1821316407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 2304) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 002304) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 2304) | |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2021-05-26 |