| NPI | 1558351973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005408) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 058602-23) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2013-09-05 |