| NPI | 1376793588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN163021) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VI 10336P) |
| 363L00000X Nurse Practitioner (Licence: CT 6713) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AK 1025) | |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2019-11-13 |