| NPI | 1356491815 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN235342)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 235342)  | 
| Enumeration Date | 2007-01-10 | 
| Last Update Date | 2022-12-08 |