| NPI | 1811215320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CT 004622) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 004622) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2012-07-05 |