| NPI | 1265782759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NH 065562-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 5062) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MA RN2286523) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2023-02-09 |