| NPI | 1134191604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 0043) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 000043) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CT 0043) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2021-03-23 |