| NPI | 1255816534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2300774) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 087529-23) |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2022-09-14 |