| NPI | 1629495379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295445) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171463) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-08-19 |