| NPI | 1710392139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 2276816) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2276816) | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2276816) | |
| Enumeration Date | 2014-06-24 | 
| Last Update Date | 2023-03-02 |