NPI | 1164584785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 035757-23) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 168256) |
Enumeration Date | 2006-12-14 |
Last Update Date | 2019-07-17 |