| NPI | 1912262973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004842) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 073864) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2014-03-19 |