| NPI | 1528619657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2320519) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2320519) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2020-01-28 |