| 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 |