| NPI | 1699430017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2297648) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA RN2297648) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 10197) | |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2023-10-14 |