NPI | 1629341516 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2263887) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2263887) |
Enumeration Date | 2012-02-23 |
Last Update Date | 2021-05-13 |