| NPI | 1730816117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2343813) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2343813) |
| 207Q00000X Family Medicine (Licence: MA RN2343813) | |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-10-25 |