| NPI | 1740640556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6484) |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: CT 130281) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |