| NPI | 1558713628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2322110) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: VA 1104957) |
| 133V00000X Dietitian, Registered (Licence: MA 4568) | |
| 163W00000X Registered Nurse (Licence: VA 0001290082) | |
| 163W00000X Registered Nurse (Licence: NY 706344) | |
| 163W00000X Registered Nurse (Licence: MA RN2322110) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178335) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 341587) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2020-05-05 |