NPI | 1194135111 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2284486) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2284486) |
Enumeration Date | 2014-04-29 |
Last Update Date | 2018-03-12 |