| NPI | 1104105865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 159440) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 003055) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |