| NPI | 1912989914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 001700) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E44416) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2012-02-09 |