| NPI | 1083155576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 6939) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F308075-1) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |