| NPI | 1518452754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA RN2312890) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2312890) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2018-12-27 |