| NPI | 1093141798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN153855) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 5533) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2020-09-02 |