| NPI | 1669019972 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN233921)  | 
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: MA RN233921)  | 
| Enumeration Date | 2019-12-05 | 
| Last Update Date | 2019-12-05 |