| NPI | 1194135111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2284486) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2284486) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2018-03-12 |