NPI | 1285278317 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 268092) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 268092) |
208000000X Pediatrics (Licence: MA 268092) | |
Enumeration Date | 2019-11-01 |
Last Update Date | 2021-10-18 |