| NPI | 1619695764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2264099) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MA RN2264099) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2023-08-10 |