| NPI | 1114805116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2390398) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2390398) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2390398) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2390398) | |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2026-01-22 |