| NPI | 1134771017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2320717) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2320717) |
| 163W00000X Registered Nurse (Licence: MA RN2320717) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2022-02-09 |