| NPI | 1912358375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: CT 12.006640) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 6640) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2023-03-07 |