| NPI | 1497785885 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN194627) | 
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA 194627) | 
| Enumeration Date | 2006-07-03 | 
| Last Update Date | 2018-10-30 |