| NPI | 1609612019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA F06250728) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN10001632) |
| Enumeration Date | 2024-07-04 |
| Last Update Date | 2025-06-15 |