NPI | 1639580038 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 270005) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH ML4251500) |
363L00000X Nurse Practitioner (Licence: MA RN270005) | |
Enumeration Date | 2014-05-20 |
Last Update Date | 2024-09-13 |