NPI | 1093105660 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 277421) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4046162) |
Enumeration Date | 2015-02-03 |
Last Update Date | 2025-09-22 |