NPI | 1588968127 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN280091) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 063772-23) |
Enumeration Date | 2010-12-22 |
Last Update Date | 2014-09-04 |