| NPI | 1548282718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA 161092) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NH 053094-23-05) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2013-03-14 |