NPI | 1194363267 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: MA RN200984) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 201912843) |
Enumeration Date | 2019-12-19 |
Last Update Date | 2019-12-19 |