NPI | 1093796989 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 107611) |
Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA 107611) |
Enumeration Date | 2005-11-08 |
Last Update Date | 2010-08-06 |