| NPI | 1962059311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA F07190239) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-10-02 |