| NPI | 1396980314 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 003908)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 003908)  | 
| Enumeration Date | 2008-12-04 | 
| Last Update Date | 2018-04-24 |