NPI | 1104443886 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 304341) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2306416) |
Enumeration Date | 2020-06-29 |
Last Update Date | 2021-09-01 |