| NPI | 1871831735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 5195) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP012496) |
| Enumeration Date | 2013-01-27 |
| Last Update Date | 2013-10-24 |