| NPI | 1518161306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 001207) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 001207) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 001207) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 001207) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2015-12-18 |