| NPI | 1750801460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2279699) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 731182-1) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308209) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2022-10-12 |