| NPI | 1760839609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA 2018015602) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 284937) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2018-08-04 |