| NPI | 1104086362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 004260) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 375031-1) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2010-05-20 |