| NPI | 1164785200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 11402) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305858-1) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2025-06-09 |