| NPI | 1104690072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2339010) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD 263302) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-04-16 |