NPI | 1063985257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2261178) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA RN2261178) |
Enumeration Date | 2019-01-10 |
Last Update Date | 2022-01-20 |