| NPI | 1164409587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 3304) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 3304) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 003304) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2022-01-27 |