| NPI | 1013513837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2329059) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2329059) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2329059) | |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2021-08-24 |