| NPI | 1215368766 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 08211323) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN279939) | 
| Enumeration Date | 2013-12-10 | 
| Last Update Date | 2022-01-21 |