| NPI | 1265060586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2330503) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 676112) |
| 163W00000X Registered Nurse (Licence: MA RN2330503) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 345075) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-06-02 |