| NPI | 1619149564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN182108) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 182108) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2020-04-27 |