| NPI | 1720560691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2266834) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2266834) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2019-02-05 |