| NPI | 1548704398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2274444) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0992168-NP) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2018-09-20 |