| NPI | 1528509585 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN233388) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9173616) | 
| Enumeration Date | 2017-03-10 | 
| Last Update Date | 2025-09-23 |