| NPI | 1093988057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 001029) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 241904) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2011-12-29 |