| NPI | 1063818425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 11515) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2292040) |
| 363L00000X Nurse Practitioner (Licence: NY 431943) | |
| 363L00000X Nurse Practitioner (Licence: MA RN2292040) | |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2025-03-11 |