NPI | 1104502285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2335114) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2335114) |
Enumeration Date | 2023-06-23 |
Last Update Date | 2024-11-12 |