| NPI | 1497740062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004573) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71000703A) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2015-06-19 |