| NPI | 1043763352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 065433-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2266243) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2020-02-13 |