NPI | 1013451921 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2287384) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 068603-23) |
Enumeration Date | 2016-12-12 |
Last Update Date | 2022-05-25 |