NPI | 1003695347 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2345321) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA RN2345321) |
Enumeration Date | 2023-09-26 |
Last Update Date | 2025-05-09 |