| NPI | 1265429229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MA 147292) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 147292) |
| 163W00000X Registered Nurse (Licence: NH 036506-21) | |
| 363L00000X Nurse Practitioner (Licence: MA 147292) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-01-24 |