| NPI | 1639364441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2268959) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 077985) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 003671) | |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2022-12-22 |