| NPI | 1770880643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 2267342) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 636173) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2019-04-29 |