| NPI | 1629663323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2367985) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 1471782) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024189548) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-162201) | |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2025-11-04 |