NPI | 1194445221 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA F08221178) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295952) |
Enumeration Date | 2022-08-30 |
Last Update Date | 2022-11-26 |