| NPI | 1891419933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2322136) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA RN2322136) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2322136) | |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-26 |