NPI | 1477105559 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2335411) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F344655-01) |
Enumeration Date | 2019-07-10 |
Last Update Date | 2019-10-18 |