| NPI | 1871996413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2338930) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 19135) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2021-03-18 |