| NPI | 1972957587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 006503) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307718) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 6503) | |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2020-03-30 |