| NPI | 1942919360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2286767) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2286767) |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2024-03-06 |