| NPI | 1154621399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2258713) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2258713) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2014-12-10 |