| NPI | 1639580038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 270005) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH ML4251500) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2017-06-13 |