| NPI | 1114039229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 002785) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 2785) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-01-13 |