| NPI | 1114509577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2350404) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: MA RN2350404) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2022-09-02 |