| NPI | 1760145643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2290340) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA AG10210012) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |