| NPI | 1669510731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 140784) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 046049-23-05) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2012-02-14 |