| NPI | 1619293230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 171867) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71003210) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2012-06-04 |