NPI | 1346548872 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN-TEMP12962) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9172583) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN9172583) | |
Enumeration Date | 2011-03-08 |
Last Update Date | 2022-01-31 |