| NPI | 1215493531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2294681) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2294681) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2021-01-02 |