| NPI | 1750889135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN271164) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN271164) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-01-31 |