| NPI | 1891934469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN179649) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA TP004019X) |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2014-12-30 |