| NPI | 1225791700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2341214) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10140) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA APRN-NP321552) | |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2025-10-02 |