| NPI | 1104870609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 001406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E55291) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 1406) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-12-08 |