| NPI | 1508418021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2272313) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2272313) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2272313) | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2020-12-11 |