| NPI | 1619165545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 3609) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 3609) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 3609) | |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2016-07-13 |