| NPI | 1801200175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN281275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 281275) |
| 363LF0000X Nurse Practitioner Family (Licence: MA 281275) | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2020-03-13 |