NPI | 1164768321 |
---|---|
Former Name | TAMARA JOSEPH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2264091) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2264091) |
Enumeration Date | 2012-12-17 |
Last Update Date | 2024-08-31 |