| NPI | 1649729559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 6777) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 91474) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2017-01-30 |