| NPI | 1174699979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 158677) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 029940-23-04) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2013-06-06 |