| NPI | 1841904174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12016) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 122728) |
| 363L00000X Nurse Practitioner (Licence: CT 12016) | |
| Enumeration Date | 2023-01-11 |
| Last Update Date | 2023-08-03 |