| NPI | 1720557572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2318541) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 309645) |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2024-03-15 |