| NPI | 1497741680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN134682) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E37913) |
| 363L00000X Nurse Practitioner (Licence: CT 001917) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2011-12-21 |