| NPI | 1205192689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CT 005176) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 005176) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2022-07-11 |