| NPI | 1659593432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 2916) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 002916) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-08-01 |