| NPI | 1962758664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 7679) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2018-11-14 |