| NPI | 1215522065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2311668) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2311668) |
| 363L00000X Nurse Practitioner (Licence: MA RN2311668) | |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2024-02-16 |