| NPI | 1811419625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2281999) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2281999) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2018-05-17 |