| NPI | 1023551736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA rn2261299) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 6850) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2021-07-27 |