NPI | 1104251602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2277693) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2277693) |
163W00000X Registered Nurse (Licence: NH 068485-21) | |
Enumeration Date | 2013-09-04 |
Last Update Date | 2015-01-09 |