NPI | 1275671257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 176839) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 176839) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2012-02-21 |