| NPI | 1528643624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295578) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2295578) | 
| Enumeration Date | 2021-03-10 | 
| Last Update Date | 2024-12-13 |