| NPI | 1376576496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 000601) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 130166) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2015-04-30 |