| NPI | 1710280136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 004582) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 77555) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2015-08-17 |