| NPI | 1558412676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: MA LYD104320170) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MA 258570) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2010-05-25 |