| NPI | 1861050403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2298515) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: MA RN2298515) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |