| NPI | 1871594788 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN10019601)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F332392)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: CT 002122)  | |
| Enumeration Date | 2005-08-02 | 
| Last Update Date | 2025-02-20 |