| NPI | 1962019117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2279901) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA RN2279901) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |