| NPI | 1649293911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 177115) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 0531032312) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NH 053103-23-12) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-10-26 |