| NPI | 1851647820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005103) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 98997) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-10-22 |