| NPI | 1346548872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN-TEMP12962) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9172583) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9172583) | |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2022-01-31 |