| NPI | 1275288979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2369820) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024183704) |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2023-03-09 |