NPI | 1306624101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2359140) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 086863-21) |
Enumeration Date | 2023-09-21 |
Last Update Date | 2024-06-12 |