| NPI | 1386113777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN2283426) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA MS1168334N) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2020-01-02 |