| NPI | 1932287075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 177919) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 177919) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-06-03 |