| NPI | 1205040219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 002835) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F333812-1) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2015-01-12 |