| NPI | 1265717631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 195985) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 035912-23) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2023-01-11 |