| NPI | 1972869824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 078502-23) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 2264625) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2019-07-10 |