| NPI | 1013213552 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 004484)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 004484)  | 
| 163WW0000X Registered Nurse, Wound Care (Licence: CT E52891)  | |
| Enumeration Date | 2011-02-01 | 
| Last Update Date | 2013-05-06 |