| NPI | 1164493243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 1331) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 001331) |
| 363L00000X Nurse Practitioner (Licence: CT 001331) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2013-10-04 |