| NPI | 1649655895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 6172) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 6172) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CT 006172) | |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2021-06-22 |