NPI | 1376258061 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2301677) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2301677) |
Enumeration Date | 2023-01-18 |
Last Update Date | 2023-05-23 |