| NPI | 1629782834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2313397) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2313397) |
| 163W00000X Registered Nurse (Licence: NH 086563-21) | |
| 363L00000X Nurse Practitioner (Licence: NH 086563-23) | |
| Enumeration Date | 2023-01-11 |
| Last Update Date | 2023-05-11 |