NPI | 1609503762 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2339563) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2022041765) |
Enumeration Date | 2022-08-08 |
Last Update Date | 2022-10-31 |