| NPI | 1740626803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 006765) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012887) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA.17537-NP) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2016-12-12 |