| NPI | 1164173530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2338962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F348948-01) |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2024-06-25 |