| NPI | 1164091963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2353271) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 163883) |
| 163W00000X Registered Nurse (Licence: MA RN2353271) | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2022-01-25 |