| NPI | 1033626841 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN10017866) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704299579) | 
| Enumeration Date | 2018-01-02 | 
| Last Update Date | 2025-01-19 |