NPI | 1124536537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2299613) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 8539) |
Enumeration Date | 2018-01-19 |
Last Update Date | 2022-09-12 |