| NPI | 1396479531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA AG06220030) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MA AG06220030) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MA AG06220030) | |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2022-11-15 |