| NPI | 1184972119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN21800) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: RI RN34865) |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2012-08-23 |