| NPI | 1265212476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2287358) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM 88152) |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2026-03-03 |