| NPI | 1114114758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 184642) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 184642) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2013-02-25 |