| NPI | 1710064795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN179676) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA NP179676) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-07-25 |