NPI | 1568822252 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2310334) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95003696) |
Enumeration Date | 2016-02-24 |
Last Update Date | 2016-10-03 |