| NPI | 1447919220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2316876) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA PENDING) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2021-12-22 |