| NPI | 1760479711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CT CT 001878) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT CT001878) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2010-08-05 |