| NPI | 1245009117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2023166240) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2363429) |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |