| NPI | 1740317965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2290704) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP-02313) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2290704) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2023-08-22 |