NPI | 1275917783 |
---|---|
Former Name | RACHAEL GREENE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112589) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2015023422) |
Enumeration Date | 2015-07-14 |
Last Update Date | 2019-04-10 |