| NPI | 1518498799 |
|---|---|
| Former Name | ANNA GOODMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2160249) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2303648) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2018-01-18 |