| NPI | 1164074654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2277460) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2277460) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-10-29 |