| NPI | 1154390326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA RN254568) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 254568) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 254568) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2023-10-06 |