| NPI | 1790821064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 232168) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 232168) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-12-22 |