| NPI | 1356998587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2301789) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 9275) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2021-09-22 |