| NPI | 1316560907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2336546) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2336546) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2022-09-09 |