| NPI | 1568149672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10013571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2349065) |
| 163W00000X Registered Nurse (Licence: MA RN2349065) | |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2026-01-21 |