| NPI | 1073709523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 003675) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 078033) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2012-02-13 |