| NPI | 1972547495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 002113) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 002113) |
| 207YS0012X (Licence: CT 002113) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-01-23 |