| NPI | 1104251396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2288033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN11761-T) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2013-09-06 |