NPI | 1578093746 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2296747) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 341876) |
Enumeration Date | 2017-06-19 |
Last Update Date | 2023-12-20 |