| NPI | 1922673912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2287077) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2287077) |
| Enumeration Date | 2021-05-23 |
| Last Update Date | 2021-10-13 |