| NPI | 1063540326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: MA 139050) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 139050) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |