| NPI | 1316516537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MA RN2340583) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2340583) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2022-02-07 |