| NPI | 1629597695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2286726) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 074819-23) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-12-27 |