| NPI | 1710603923 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2330101) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN03297) | 
| Enumeration Date | 2022-10-19 | 
| Last Update Date | 2025-03-19 |