NPI | 1053994558 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2289980) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 084593-23) |
Enumeration Date | 2021-05-03 |
Last Update Date | 2021-10-14 |