NPI | 1205117439 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN235272) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 4777) |
Enumeration Date | 2011-09-01 |
Last Update Date | 2014-06-05 |