| NPI | 1073143038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2291250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA RN2291250) |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |