| NPI | 1407119878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2270021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704320601) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2016-09-28 |