| NPI | 1114513694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA rn2278851) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2278851) |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2025-04-03 |