| NPI | 1679957153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN271339) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA RN271339) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2016-06-08 |