| NPI | 1558792739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2297910) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013429) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2020-07-03 |