| NPI | 1124557368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2306932) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2306932) |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2018-10-31 |