| NPI | 1093101149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 006071) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E51427) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 006071) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2018-04-09 |