| NPI | 1790467397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN2347277) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN2347277) |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-17 |