| NPI | 1639623085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN285181) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN285181) |
| Enumeration Date | 2016-08-14 |
| Last Update Date | 2026-09-01 |