| NPI | 1922650001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2333981) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020271) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-10-17 |