| NPI | 1710646252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2337506) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2337506) |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2022-06-03 |