| NPI | 1104220805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2308623) |
| Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: CA 95031319) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95026608) | |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2024-02-15 |