| NPI | 1760764021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN192101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 192101) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2017-12-22 |