| NPI | 1740516012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN278449) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN278449) |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2021-01-09 |