| NPI | 1821101833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN173593) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 003421) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-12-24 |