| NPI | 1679034441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 259406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 259406) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2020-12-01 |