NPI | 1053736629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2318010) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH #055397-23) |
Enumeration Date | 2014-02-19 |
Last Update Date | 2018-06-12 |