| NPI | 1457321564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 028153222) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 031103123) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2007-07-08 |