NPI | 1114349529 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2277694) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2277694) |
Enumeration Date | 2014-01-21 |
Last Update Date | 2014-09-19 |