| NPI | 1073381638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2391737) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 14632) |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2026-08-08 |