| NPI | 1407913478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 054348-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2300018) |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 054348-23-03) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2021-03-18 |