| NPI | 1174033468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2363559) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F308391) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2022-10-25 |