| NPI | 1124848601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2371025) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN2371025) |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-11-21 |