| NPI | 1043857782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2275954) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MA Rn2275954) |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2019-12-02 |