NPI | 1104175520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 005131) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CT E56601) |
363L00000X Nurse Practitioner (Licence: CT 005131) | |
Enumeration Date | 2012-08-30 |
Last Update Date | 2015-12-08 |