| NPI | 1942592399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN243161) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA RN243161) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2016-07-29 |