| NPI | 1063976728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2353273) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343648) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2022-03-04 |