| NPI | 1053771964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA F07170084) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2261476) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2020-07-07 |