| NPI | 1982204715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9210) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 137290) |
| 163W00000X Registered Nurse (Licence: MA RN2309851) | |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-12-10 |