| NPI | 1548813165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 190987) |
| Additional Taxonomies | 163WX1100X Registered Nurse, Ophthalmic (Licence: MA 190987) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 190987) | |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2021-04-13 |