| NPI | 1730486812 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2269723) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2269723) | 
| Enumeration Date | 2011-02-25 | 
| Last Update Date | 2014-09-02 |