| NPI | 1083028716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2300531) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1123930) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2019-06-03 |