| NPI | 1013305515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005961) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 094418) |
| 363L00000X Nurse Practitioner (Licence: CT 5961) | |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2016-03-28 |