| NPI | 1942591698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN279943) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 005345) |
| 363L00000X Nurse Practitioner (Licence: CT 005345) | |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2015-06-19 |