| NPI | 1376041905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2134399) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MA RN2314399) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2021-05-06 |