| NPI | 1376697219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 260266) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 0542022303) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2008-10-06 |