| NPI | 1033490461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 8836) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 7956638-4405) | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: UT 7956638-4405) | |
| Enumeration Date | 2011-08-30 | 
| Last Update Date | 2020-09-21 |