| NPI | 1699772715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA NP242569) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA NP/RN 242569) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2018-10-04 |