| NPI | 1639862329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2358425) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 84552) |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2025-09-30 |