NPI | 1083097778 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2290979) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN00711) |
Enumeration Date | 2015-06-30 |
Last Update Date | 2016-08-25 |