| NPI | 1124407945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN265055) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MA RN265055) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-29 |