| NPI | 1629557574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN232823) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN232823) |
| Enumeration Date | 2018-08-11 |
| Last Update Date | 2018-12-28 |