| NPI | 1679787469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 232083) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 1497) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-08-31 |