| NPI | 1639803133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2348081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2348081) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2348081) | |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2023-12-03 |