| NPI | 1508603176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2269733) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2269733) |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2025-04-03 |