| NPI | 1992348502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN193989) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA AG09190171) |
| Enumeration Date | 2019-10-26 |
| Last Update Date | 2022-04-11 |