| NPI | 1568408433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 003608) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: SD R030966) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 003608) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2015-10-13 |