| NPI | 1255418414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 002258) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 002258) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 002258) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-04-12 |