| NPI | 1669516662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 001699) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 1982902) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2017-01-24 |