| NPI | 1255616330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2283715) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 004780) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2013-04-11 |