| NPI | 1700990264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 003064) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CT 003064) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CT 003064) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-02-10 |