| NPI | 1487163945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2306058) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 342256) |
| 363L00000X Nurse Practitioner (Licence: NY 342256) | |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-09-21 |