| NPI | 1083682397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA 251391) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN251391) |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2012-03-28 |