| NPI | 1629069257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 003798) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA VP006124B) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 003798) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2014-06-05 |