| NPI | 1053169896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2023210346) |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-29 |