| NPI | 1043524077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2265252) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L100390393) |
| 163W00000X Registered Nurse (Licence: MA RN2265252) | |
| 163W00000X Registered Nurse (Licence: PA RN565914) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95000976) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2014-07-22 |