NPI | 1093006884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2269436) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 004713) |
Enumeration Date | 2011-04-27 |
Last Update Date | 2013-01-10 |