| NPI | 1831558097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 006955) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 129997) |
| 163W00000X Registered Nurse (Licence: NY 700723) | |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2018-03-17 |