| NPI | 1962013581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2300402) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MS 892400) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS 903986) | |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 215704) | |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2024-06-25 |