NPI | 1467849331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2337170) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18680) |
Enumeration Date | 2015-04-18 |
Last Update Date | 2020-02-20 |