| NPI | 1043305402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 002918) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 002918) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-01-27 |