| NPI | 1083151260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2282943) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MA RN2282943) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2018-01-24 |