| NPI | 1730621491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 078747-23) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2286908) |
| Enumeration Date | 2016-11-12 |
| Last Update Date | 2018-11-08 |