| NPI | 1275815417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2267753) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 6380) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2267753) | |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2022-07-21 |