NPI | 1285190645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2347653) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 4653) |
Enumeration Date | 2019-02-11 |
Last Update Date | 2023-04-11 |