| NPI | 1932769122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2307649) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2307649) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-06-26 |