NPI | 1639174535 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN124491) |
Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MA 124491) |
Enumeration Date | 2005-06-16 |
Last Update Date | 2024-07-25 |