| NPI | 1588704522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2311625) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 392220) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2019-04-02 |