| NPI | 1609424704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2336974) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142524) |
| Enumeration Date | 2019-08-31 |
| Last Update Date | 2019-11-15 |