| NPI | 1558025312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2288782) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA AG09210191) |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2023-01-12 |