| NPI | 1750583944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 001965) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 170133) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2014-06-18 |