| NPI | 1619632726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2309048) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 082678-23) |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2022-10-31 |