| NPI | 1144639337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2290481) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2290481) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NH 070039-23) | |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2018-07-18 |