| NPI | 1093800583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 236867) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 236867) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-04-29 |