| NPI | 1962959205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2309341) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2309341) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2023-05-11 |