| NPI | 1104803899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 077684-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 001963) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2023-03-07 |