| NPI | 1073652459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LS0200X Nurse Practitioner School (Licence: MA 184272) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 184272) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2013-03-31 |