| NPI | 1417923772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 100165) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 100165) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-03-07 |