| NPI | 1881747194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 151796) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN151796) |
| 363LW0102X Nurse Practitioner Women's Health (Licence: MA RN151796) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2019-01-24 |