| NPI | 1679228704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2345077) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN F02220373) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2023-11-17 |