NPI | 1598198079 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2277498) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5469) |
Enumeration Date | 2013-08-19 |
Last Update Date | 2016-05-05 |