| NPI | 1770658395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NH 078790-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2289350) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2021-08-04 |