| NPI | 1306485396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN230378) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: FL 11002027) |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2020-10-21 |