| NPI | 1558694760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN285156) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN285156) |
| 363L00000X Nurse Practitioner (Licence: WV 81518) | |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2020-11-16 |