| NPI | 1659883668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2261033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 623762-1) |
| 363L00000X Nurse Practitioner (Licence: NY F431173-1) | |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2020-04-19 |