| NPI | 1174071286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 272764) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 047111-23) |
| Enumeration Date | 2016-09-18 |
| Last Update Date | 2017-12-05 |