| NPI | 1912579392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA F07221644) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2350674) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2022-08-01 |