NPI | 1366060360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2297223) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2297223) |
Enumeration Date | 2020-07-07 |
Last Update Date | 2022-01-31 |