| NPI | 1003696550 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2361528)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2361528)  | 
| Enumeration Date | 2023-10-03 | 
| Last Update Date | 2025-03-20 |