| NPI | 1902494768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA 2299719) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA MCS004262B) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2022-08-09 |