| NPI | 1689138844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2273261) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 136966) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-01-22 |