| NPI | 1619512886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2343275) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP021127) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2021-04-05 |