| NPI | 1780810523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 004160) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 071270) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 004160) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2018-03-06 |