| NPI | 1306566146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2310646) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 311000) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2024-06-21 |