| NPI | 1962989483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.007682) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.134972) |
| 163W00000X Registered Nurse (Licence: MA RN2311110) | |
| 163W00000X Registered Nurse (Licence: ME RN70486) | |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2020-04-15 |