| NPI | 1841838539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2329957) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95011047) |
| 363L00000X Nurse Practitioner (Licence: FL 11001849) | |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |