| NPI | 1275178998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2319516)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2319516)  | 
| Enumeration Date | 2019-11-18 | 
| Last Update Date | 2024-12-09 |