| NPI | 1942823836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2287112) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 8864) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2021-08-31 |