| NPI | 1497129654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 2291213) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2291213) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MA 2291213) | |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2020-04-08 |