NPI | 1093917213 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN169231) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 002903) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2019-06-14 |