NPI | 1063983690 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2313871) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 042820-23) |
Enumeration Date | 2018-12-07 |
Last Update Date | 2019-08-07 |