| NPI | 1093006884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2269436) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 004713) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2013-01-10 |