| NPI | 1790020188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2270709) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2270709) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2017-12-11 |