| NPI | 1528060092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 96481) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 96481) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2007-07-08 |