| NPI | 1295344547 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN273382) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN273382) | 
| Enumeration Date | 2020-07-23 | 
| Last Update Date | 2022-02-04 |