| NPI | 1275873184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MA RN264150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN264150) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MA RN264150) | |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2014-09-18 |