| NPI | 1336668011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2258522) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2258522) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2024-12-06 |