| NPI | 1104363530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 4995) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2019-08-21 |