NPI | 1336516905 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 274142) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 274142) |
Enumeration Date | 2015-08-30 |
Last Update Date | 2018-08-30 |