| NPI | 1912609124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2280947) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2280947) |
| 363LF0000X Nurse Practitioner Family (Licence: NH 084189-23) | |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-05-18 |