NPI | 1336775618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA rn274422) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN274422) |
Enumeration Date | 2020-03-18 |
Last Update Date | 2023-11-01 |