| NPI | 1104317957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 2322258) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2322258) |
| 363L00000X Nurse Practitioner (Licence: SC 28528) | |
| Enumeration Date | 2018-05-27 |
| Last Update Date | 2024-04-03 |