| NPI | 1689212730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2328958) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2328958) |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2020-10-08 |