| NPI | 1043614886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6069) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 006069) |
| 363LF0000X Nurse Practitioner, Family (Licence: RI NPP37938) | |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2016-04-13 |