NPI | 1407574833 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2339634) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704401441) |
Enumeration Date | 2022-08-22 |
Last Update Date | 2023-11-02 |