| NPI | 1649725656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 6670) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 102579) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2017-06-20 |