NPI | 1184238438 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95019090) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 2331579) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2331579) | |
Enumeration Date | 2020-09-03 |
Last Update Date | 2021-11-17 |