| NPI | 1740474998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 268239) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 268239) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-10-27 |