| NPI | 1912257627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2262988) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 2262988) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2018-03-17 |