| NPI | 1710450416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN150403) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 7847) |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |