| NPI | 1679270417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA RN2356171) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2356171) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: MA 2356171) | |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2026-04-22 |