| NPI | 1700450301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2303082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2303082) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2025-09-30 |