| NPI | 1760612162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 7042) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 588115-1) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305135-1) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2020-06-23 |