| NPI | 1356881676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2354877) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP133272) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 008409) | |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2021-08-16 |