NPI | 1093238578 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2262404) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 202004903NP-PP) |
Enumeration Date | 2017-07-17 |
Last Update Date | 2024-11-14 |