| NPI | 1740558402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 279987) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 279987) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2018-06-28 |