| NPI | 1669633764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 282358) |
| Additional Taxonomies | 261QV0200X Clinic/Center, VA |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2025-06-20 |