| NPI | 1164684551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 263105) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 263105) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2011-10-28 |