| NPI | 1023661808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2355907) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP95011300) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2021-11-02 |