| NPI | 1912407875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: MA RN265036) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 056474-23) |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2020-02-12 |