| NPI | 1922058155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2279685) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 110694) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-01-06 |