| NPI | 1083348809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2363308) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2363308) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 3104) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2363308) | |
| Enumeration Date | 2022-07-16 |
| Last Update Date | 2025-07-15 |