| NPI | 1164799482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN213169) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013950) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA RN723616) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 213169) | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2023-04-21 |