NPI | 1235605734 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2351911) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 342702) |
Enumeration Date | 2018-10-23 |
Last Update Date | 2022-01-25 |