| NPI | 1902429459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 11144) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2310279) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2022-11-30 |