| NPI | 1255959961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2335358) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2335358) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2335358) | |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2021-07-28 |