NPI | 1417574930 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11414) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2298812) |
Enumeration Date | 2020-06-30 |
Last Update Date | 2023-03-31 |