| NPI | 1568835486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2286524) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2286524) |
| 363L00000X Nurse Practitioner (Licence: WA AP60623185) | |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2022-10-11 |