| NPI | 1053913640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2259884) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2259884) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-09-30 |