| NPI | 1861273773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2308235) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F349061) |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2024-06-04 |