| NPI | 1174931687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 5798) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2311497) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2018-01-15 |