| NPI | 1114903812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 001209) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 001209) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2015-07-28 |