| NPI | 1942828504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11013102) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA F07200209) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2021-12-17 |