| NPI | 1790151967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2264353) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2264353) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2016-01-04 |