| NPI | 1083380893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN269587) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MA rn269587) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2022-04-01 |