| NPI | 1205231263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN350931) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014416) |
| Enumeration Date | 2014-11-01 |
| Last Update Date | 2022-01-25 |