| NPI | 1043832116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN10015428) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 170531) |
| 363L00000X Nurse Practitioner (Licence: CT 9116) | |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-01-17 |