NPI | 1255982484 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2368941) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2368941) |
163WP0200X Registered Nurse, Pediatrics (Licence: NC 266604) | |
363LF0000X Nurse Practitioner, Family (Licence: NC F09191895) | |
Enumeration Date | 2019-09-29 |
Last Update Date | 2024-02-10 |