NPI | 1255700167 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2292032) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2292032) |
Enumeration Date | 2015-09-21 |
Last Update Date | 2023-09-26 |