| NPI | 1609028455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 001105) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 001105) |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: CT 001105) | |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2013-03-08 |