| NPI | 1235474339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN275741) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA AG09200089) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2020-09-20 |