| NPI | 1568822252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2310334) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95003696) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2016-10-03 |