| NPI | 1700928124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 003554) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 074791) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2016-04-19 |