| NPI | 1306079819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8109) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 335505) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2019-08-20 |