| NPI | 1780238659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MA RN2310738) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA AG07190264) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2022-08-22 |