| NPI | 1659914851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN10014643) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM 64834) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 345144) | |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2024-11-11 |