| NPI | 1124313440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004764) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 082489) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-08-30 |