| NPI | 1336635580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2366152) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 223691) |
| 363L00000X Nurse Practitioner (Licence: SC 22043) | |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2022-08-15 |