| NPI | 1578818498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 774686) |
| 163W00000X Registered Nurse (Licence: CT 107156) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-10-22 |