| NPI | 1649679523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2323308) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001179) |
| Enumeration Date | 2014-08-17 |
| Last Update Date | 2019-04-13 |