| NPI | 1053994558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2289980) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 084593-23) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-10-14 |