| NPI | 1346780525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 2312682) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2312682) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2312682) | |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2024-03-21 |