| NPI | 1902900053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: CT 000010) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2018-09-27 |