| NPI | 1275930513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN282365) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95001550) |
| 363L00000X Nurse Practitioner (Licence: DC RN1041965) | |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2018-10-17 |