| NPI | 1952904351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2330795) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2330795) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2022-10-17 |