| NPI | 1699277012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2297456) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2297456) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-05-01 |