| NPI | 1508903246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 123333) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 0251512303) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2013-11-13 |