| NPI | 1063834109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN2277785) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: MA RN2277785) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2017-12-22 |