| NPI | 1790256469 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 084620-23) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2290948) | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R211101) | |
| Enumeration Date | 2018-12-06 | 
| Last Update Date | 2025-06-24 |