| NPI | 1093796989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA 107611) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: MA 107611) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2010-08-06 |