| NPI | 1790264828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2306004) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008213A) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2021-02-12 |