| NPI | 1609475755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA CNP-COND2376078) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310452) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2023-03-28 |