| NPI | 1164067831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN275919) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: MA RN275919) |
| Enumeration Date | 2019-11-17 |
| Last Update Date | 2020-03-23 |