| NPI | 1225497431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2262189) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP015913) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |