| NPI | 1043542160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN279712) |
| Additional Taxonomies | 193200000X Multi-Specialty (Licence: NJ 26NJ00656300) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2019-11-08 |