| NPI | 1215034806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LS0200X Nurse Practitioner, School (Licence: CT 003450) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 003450) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 003450) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2018-10-25 |