| NPI | 1699012591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 079158) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9286392) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2014-03-30 |