| NPI | 1831259266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 233295) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F305671) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-12-06 |