NPI | 1023614286 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10643) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2273018) |
Enumeration Date | 2020-12-11 |
Last Update Date | 2022-06-27 |