| NPI | 1861473662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA 212417) |
| Additional Taxonomies | 163WP2201X Registered Nurse Ambulatory Care (Licence: MA 212417) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2008-11-07 |