| NPI | 1003307596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2337712) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9267015) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2020-04-16 |