NPI | 1548813165 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 190987) |
Additional Taxonomies | 163WX1100X Registered Nurse, Ophthalmic (Licence: MA 190987) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MA 190987) | |
Enumeration Date | 2019-07-23 |
Last Update Date | 2021-04-13 |