| NPI | 1548781560 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 007181)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 007181)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-29 | 
| Last Update Date | 2017-10-12 |