NPI | 1407312192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2305591) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01912) |
Enumeration Date | 2019-02-18 |
Last Update Date | 2022-10-24 |