| NPI | 1609503762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2339563) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 2022041765) |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2022-10-31 |