| NPI | 1104648427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2346918) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2346918) |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-01-06 |