| NPI | 1073911210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6693) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2289776) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2016-10-10 |