| NPI | 1689648453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 001933) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E52450) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 001933) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2017-06-19 |