| NPI | 1912379710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN194965) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN194965) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2023-01-31 |