| NPI | 1780318592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2363586) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN236586) |
| Enumeration Date | 2022-07-16 |
| Last Update Date | 2025-01-29 |