NPI | 1215548052 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2330304) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2330304) |
363LF0000X Nurse Practitioner, Family (Licence: HI APRN-5017) | |
Enumeration Date | 2020-08-14 |
Last Update Date | 2025-07-11 |