| NPI | 1275867301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 4206) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2262902) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2018-03-29 |