| NPI | 1962608927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8417) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8417) |
| 363L00000X Nurse Practitioner (Licence: TX 658684) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2019-09-10 |