| NPI | 1336743988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2318915) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA F10201517) |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2021-05-10 |