| NPI | 1124130059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 4495) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 051739-23-05) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-03-21 |