| NPI | 1891103958 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN283356) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 283356) | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA RN283356) | |
| Enumeration Date | 2014-07-31 | 
| Last Update Date | 2021-02-03 |