| NPI | 1790436673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2371680) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 257383) |
| 163W00000X Registered Nurse (Licence: MA RN2371680) | |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-12-01 |