| NPI | 1144210261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN259428) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 053185-23) |
| 363L00000X Nurse Practitioner (Licence: MA 259428) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2021-08-18 |