| NPI | 1619275567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 004589) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 004589) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305505) | |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2012-02-10 |