| NPI | 1912099052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 205368) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9387604) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-04-12 |