| NPI | 1306079470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN203526) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 203525) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2014-05-22 |