| NPI | 1790924413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA F12200684) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2257742) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2023-09-08 |