| NPI | 1154436541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2262989) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MA 2030) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-06-27 |