| NPI | 1912464512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA RN2279868) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2279868) |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2020-02-21 |