| NPI | 1275817652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2264342) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 806756) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 21340) | |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2021-04-15 |