NPI | 1629799192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2337771) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2337771) |
Enumeration Date | 2022-09-05 |
Last Update Date | 2025-03-17 |