| NPI | 1962605428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN254646) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 254646) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2014-09-19 |