| NPI | 1780182329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2306553) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2306553) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2019-02-05 |