| NPI | 1194265744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2367980) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95104464) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95006063) | |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2022-12-07 |