| NPI | 1316381122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN159433) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 159433) |
| 282N00000X General Acute Care Hospital (Licence: MA 159433) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2016-04-07 |