| NPI | 1720362577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005206) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 1243) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2014-06-03 |