| NPI | 1689629297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 190859) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 190859) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-03-31 |