| NPI | 1801292958 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005916) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005916) | 
| Enumeration Date | 2014-11-17 | 
| Last Update Date | 2015-01-02 |