| NPI | 1811903230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 004880) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MA 2215) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2012-01-23 |