| NPI | 1609093921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 000737) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 063114) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2013-03-15 |