| NPI | 1982199626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA 286977) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214891) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2021-08-18 |