| NPI | 1164893582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2314396) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R192257) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2314369) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2023-05-19 |