NPI | 1164875639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2300100) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2300100) |
Enumeration Date | 2016-07-19 |
Last Update Date | 2025-04-21 |