| NPI | 1316497662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 6739) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: CT 6379) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 6739) | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2021-12-09 |