| NPI | 1285971747 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-1620A) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2268311) | 
| Enumeration Date | 2013-01-03 | 
| Last Update Date | 2024-07-09 |