| NPI | 1588893465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 4468) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 264550) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2015-08-27 |