| NPI | 1558061986 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2335918) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MA RN2335918) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2024-05-04 |