| NPI | 1518228436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN/NP204682) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN204682) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-07-29 |