| NPI | 1245752310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2281880) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP017621) |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2021-09-08 |