| NPI | 1053866384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2265663) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2265663) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2019-07-12 |