| NPI | 1104346808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2328086) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN696207) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP017742) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2019-06-26 |