| NPI | 1528619657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN2320519) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: MA RN2320519) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2024-09-19 |