| NPI | 1053006189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2358579) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2358579) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2358579) | |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-07-20 |