NPI | 1477051696 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 011178) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2262129) |
Enumeration Date | 2018-01-23 |
Last Update Date | 2023-02-07 |