| NPI | 1982014098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 251758) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: MA 251758) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2023-12-07 |