| NPI | 1023608080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295030) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2295030) |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2021-03-16 |