| NPI | 1245674720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 006352) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 006352) |
| 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CT 82526) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2016-05-09 |