| NPI | 1609855162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 001667) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 169316) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2009-06-04 |