| NPI | 1881663391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 060023-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 147797) |
| 363LF0000X Nurse Practitioner Family (Licence: MA 147797) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2009-04-29 |