| NPI | 1558441634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN159213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02241) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 159213) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-05 |