| NPI | 1063602183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA 145727) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN145727) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2024-01-31 |