NPI | 1326620246 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25838) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 347600) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2332554) | |
Enumeration Date | 2021-04-21 |
Last Update Date | 2022-09-26 |