| NPI | 1053727339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2292924) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 673582) |
| 163W00000X Registered Nurse (Licence: MA RN2292924) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2292924) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2016-03-01 |