| NPI | 1023170537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2268102) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 302568) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2014-02-23 |