NPI | 1174145841 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2279588) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN02291) |
Enumeration Date | 2020-05-15 |
Last Update Date | 2024-01-12 |