NPI | 1487279303 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2331306) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2331306) |
Enumeration Date | 2020-06-16 |
Last Update Date | 2024-04-10 |