| NPI | 1124699350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2304341) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN67916) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2304341) | |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2022-06-20 |