| NPI | 1053736629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2318010) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NH #055397-23) |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2018-06-12 |