| NPI | 1164076899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA pending) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2288027) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2023-09-01 |