| NPI | 1275964892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2300387) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 751098) |
| Enumeration Date | 2013-12-07 |
| Last Update Date | 2020-11-01 |