| NPI | 1811959174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 114492) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MA 114492) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2007-07-08 |