| NPI | 1003299090 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2283838) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2283838) | 
| Enumeration Date | 2015-07-08 | 
| Last Update Date | 2023-05-31 |