| NPI | 1306563754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN10021393) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN10021393) |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2025-11-03 |