| NPI | 1649822958 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 076746-23) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN275865) | 
| Enumeration Date | 2019-07-16 | 
| Last Update Date | 2023-07-10 |