| NPI | 1265787170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005077) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 99543) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2020-03-04 |