| NPI | 1245636877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 0058973) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 05969) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2017-12-14 |