| NPI | 1962681726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN234454) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: MA 234454) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: MA 234454) | |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2012-01-12 |