NPI | 1568457083 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 207263) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 112096-23) |
Enumeration Date | 2005-09-12 |
Last Update Date | 2025-01-07 |