NPI | 1073980207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9980) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00583300) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2311289) | |
Enumeration Date | 2015-08-24 |
Last Update Date | 2023-12-15 |