| NPI | 1942662812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2334487) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000020857) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-03-18 |