| NPI | 1639713902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2289441) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2289441) |
| 363L00000X Nurse Practitioner (Licence: NJ 26NJ14946700) | |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2025-02-04 |