NPI | 1225791700 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2341214) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10140) |
Enumeration Date | 2021-10-20 |
Last Update Date | 2022-02-16 |