| NPI | 1700759602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2270767) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA Rn2270767) |
| Enumeration Date | 2025-09-26 |
| Last Update Date | 2026-04-17 |