| NPI | 1659762714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2269898) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2269898) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: VA 0024172332) | |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2021-09-22 |