| NPI | 1750509063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 189236) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 189236) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2018-03-17 |