| NPI | 1649491655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN252799) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 252799) |
| 363L00000X Nurse Practitioner (Licence: MA A0806349) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2023-05-03 |