| NPI | 1235558131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MA NP2261021) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2261021) |
| 363LF0000X Nurse Practitioner Family (Licence: MA NP2261021) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2024-04-21 |